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Plateau-wave phenomenon (II). Occurrence of brain herniation in patients with and without plateau waves.
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From 1980 to 1989, during intracranial pressure (ICP) recording, brain herniation (central transtentorial herniation associated with uncal herniation) developed in 15 patients as a result of aneurysmal rebleeding, uncontrollable brain swelling and/or oedema in spite of attempts at treating increased ICP. The relationship between the ICP level at which herniation occurred and the ICP fluctuation patterns in continuous ICP recordings prior to the development of the herniation was studied retrospectively. As for the ICP fluctuation patterns, the patients were assigned to 2 groups on the basis of the presence or abscence of plateau waves of Lundberg: group I comprising 8 patients without plateau waves but with a high ICP, and group II comprising 7 patients with both plateau waves and a high ICP.
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